Abstract
This paper describes an increasingly prevalent type of patient seen in San Francisco, a city which is often regarded as a social trend-setter. Such patients are characterized by social and material success, diffusion or reversal of traditional sex roles, acceptance of any sexual behaviour and instability of all relationships. The resultant insecurity leads to heavy reliance on self-help books and pseudo-therapies, often with disastrous results. Conventional therapeutic methods seem inapplicable, the task being apparently more one of education than therapy.